What do we need to change for our next IVF cycle

After her IVF cycle failed, a patient sent me this email

In retrospect what do you think could have gone wrong? Is there anything I need to improve or change ? 

It's important to learn from each IVF cycle by analysing what went, and what didn't. The right time to do this is at the time of embryo transfer, because it is only until this point that we have any control. We can only three tangible variables -

embryo quality

endometrial ( receptivity) thickness and texture

the ease of the transfer

Once the embryos have been transferred into the uterus, we have no ability to check what happens inside the uterus. All we know is that human reproduction is not a very efficient process, and that most embryos will not implant because they have genetic abnormalities we still cannot test for. This is the limitation of IVF technology today, and we need to come to terms with it.

This was my answer to her.

No, there's no need to change anything, since it was a perfect cycle ( top quality blastocyst, excellent endometrium, easy transfer)

The problem is that human reproduction is not perfect !

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